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*WlwG Neuro (Strokes/Tumours) Flashcards

1
Q

Cavum (anterior)

A

Cavum septum pellucidum

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2
Q

Cavum (whole)

A

Cavum vergae

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3
Q

Cavum (posterior)

A

Cavum veli interpositi

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4
Q

What does anterior choroideal artery supply?

A

Hippocampus (“Korea Hippo”)

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5
Q

What does lenticulostriate artery supply?

A

Basal ganglia and caudate

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6
Q

Territories: ICA

A

Contra everything

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7
Q

Territories: ACA

A

Contra lower limb

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8
Q

Territories: MCA

A

Contra upper limb, aphasia, homonymous hemianopia

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9
Q

Territories: Lacunar

A

Contra ACA + MCA

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10
Q

Territories: PCA

A

Contra reduced visual recognition, homonymous hemianopia with macula sparing

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11
Q

Territories: Retinal/opthalmic artery

A

Ipsilateral amaurosis fugax/blindness

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12
Q

Territories: PICA/Lateral medullary syndrome/Wallenberg syndrome

A

Ipsilateral horners/facial sensory/cerebellar, CONTRA limb sensory

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13
Q

Territories: Pontine

A

Ipsilateral CN6 horizontal gaze palsy

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14
Q

Territories: Basilar

A

Cerebellum + pons + CN3 palsy

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15
Q

Cerebral infarct: CT appearance

A

Hypodense throughout, hyperdense if haemorrhagic conversion at 1-4 weeks

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16
Q

Cerebral infarct: MRI appearance DWI

A

DWI-high/ADC-low acute to subacute, DWI/ADC-high when chronic

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17
Q

Cerebral infarct: MRI appearancec T2/FLAIR

A

Iso in acute, bright in subacute and chronic

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18
Q

Appearance of CNS vasculitis

A

Rapidly progressive T2-hyper with infarcts/haemorrhages

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19
Q

Appearance of Moyamoya

A

Watershed infarcts in kid with increased collaterals (basal ganglia)

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20
Q

Appearance of venous sinus thrombosis on CT and MRI

A

CT pre-contrast hyperdense, post-contrast hypodense clot
MRI T1-iso, T2-hypo during acute

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21
Q

Bleed: CT appearance

A

Bright in acute, gradual decrease, dark in chronic

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22
Q

Bleed: MRI apperance

A

<1 day hyperacute: T1-iso, T2-bright
2 days acute: T1-iso, T2-dark
>3 days early subacute: T1-bright, T2-dark
1-4 weeks late subacute: T1-bright, T2-bright
>4 weeks chronic T1-dark, T2-dark

(“T-oNe “n”, T-2U “U”) (“1234 212 Both” = Hyper Iso-Bri, Acute T2 dark, Early sub T1-bright, Late sub T2-bright, Chronic both dark”)

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23
Q

Bleed: Epidural appearance

A

Biconvex, not crossing suture/falx/tentorium but can cross midline (as superficial), associated with skull fracture

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24
Q

Bleed: HTN

A

Central (BG/pons)

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25
Q

Bleed: Subdural

A

Crescent, crossing suture but not falx/tentorium

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26
Q

Bleed: SAH

A

Random shape, blood in CSF spaces

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27
Q

Bleed: DAI

A

Multi-focal tiny T2-hyper bleeds at grey-white interface after trauma

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28
Q

Small aneurysms

A

Saccular berry aneurysm from PCKD/coarc/marfans/NF1

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29
Q

Large aneurysm with calcification

A

Giant aneurysm

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30
Q

Aneurysm at distal MCA

A

Mycotic aneurysm, from infn/IVDU/endocarditis

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31
Q

Aneurysm at posterior circulation (small)

A

Fusiform aneurysm, from connective tissue disorders

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32
Q

Aneurysm at posterior circulation (elongated)

A

Atherosclerotic aneurysm

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33
Q

Serpiginous arterial malformation

A

AVM

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34
Q

Medusa-head venous malformation

A

Anomalous medullary vein

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35
Q

Popcorn blooming susceptibility artefacts

A

Cavernoma

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36
Q

Signs of cavernous sinus thrombosis

A

CN3 palsy, peri-orbital swelling, exopthalmus, headache. Dense filling defect with distended cavernous sinus on CT/MRI

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37
Q

Artery and nerve involved in brain herniation

A

Basilar artery, PCA and CN3

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38
Q

Subdural CSF after trauma

A

Subdural hygroma

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39
Q

Loss of G-W interface

A

Cerebral oedema

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40
Q

Neuro enhancements: Extra-axial signs?

A

CSF cleft, next to grey matter but not white matter, enlarged subarachnoid space, bone involvement, +/- dural tail

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41
Q

Neuro enhancements: Extra-axial with dural tail dx

A

Meningioma/Dural mets

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42
Q

Neuro enhancements: Extra-axial without dural tail

A

Schwannoma/other tumours

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43
Q

Neuro enhancements: Intra-axial sub-cortical nodular with oedema

A

Mets

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44
Q

Neuro enhancements: Intra-axial sub-cortical nodular without oedema, peri-ventricle

A

MS

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45
Q

Neuro enhancements: Intra-tentorial nodular in young

A

Pilocytic astrocytoma

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46
Q

Neuro enhancements: Thin wall, T2-hypo, necrotic center, ring enhancement

A

Abscess

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47
Q

Neuro enhancements: Corpus callosum with secondary lesions

A

GBM

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48
Q

Neuro enhancements: Solitary with ventricle involvement

A

Lymphoma

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49
Q

Neuro enhancements: <1cm with thin walls and calcs

A

NeuroCystiCercosis (taenia tapeworm from pigs)

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50
Q

Neuro enhancements: Multiple in basal ganglia with HIV

A

Toxoplasmosis

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51
Q

Neuro enhancements: Enhancement around gyrus and brainstem dx and conditions

A

Lepto-meningeal (meningitis/encephalitis/infarct)

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52
Q

Neuro enhancements: Enhancement just under skull and falx dx and conditions

A

Pachy-meningeal (mets/sarcoid/TB/lymphoma)

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53
Q

MR Spect: Meaning of upslope, downslope, lactate, lipid

A

Normal = upslope = Choline left-most and lowest, Creatinine center, NAA right-most and highest
Downslope (ie high Choline, low NAA) = Cancer
Presence of lactate = Inflm/Stroke/Cancer
Presence of lipid = Stroke (“Fat people get stroke”)

54
Q

Neuro lesions: Multiple

A

MMMM = MS, mets, multi-focal malignancy (GBM, Lymphoma)

55
Q

Neuro lesions: Mets causes

A

GBK + LM (GIT, breast, kidney, lung, melanoma)

56
Q

Neuro lesions: Calcific tumours

A

Old MAGE = OligodendroGlioma, Meningioma, Astro, Ependy, Glioblastoma

57
Q

Neuro lesions: Appearance of DNET

A

DCBNET = Doesn’t enhance (usually), child, bubbly, nodular-cystic, epilepsy, temporal lobe

58
Q

Neuro adult lesions: Frontal tumour

A

Oligodendro

59
Q

Neuro adult lesions: Peri-ventricular tumour

60
Q

Neuro adult lesions: Temporal

A

GanglioGlioma

61
Q

Neuro adult lesions: Cerebellar cyst with enhancing nodule

A

Haemangioblastoma (VHL)

62
Q

Neuro adult lesions: Anywhere with calcs

63
Q

Neuro child lesions: Infra-tentorial, hetero enhancement

A

Teratoma/Rhabdoid

64
Q

Neuro child lesions: Intra-tentorial, homo enhancement, hydrocephalus, CT-hyper, no calcs

A

Medulloblastoma
(compare glioma/astrocytoma is CT-iso/hypo and with calcs)

65
Q

Neuro child lesions: Cyst with enhancing nodule, focal

A

Pilocytic astrocytoma
(Compare medulloblastoma is CT-hyper. Compare diffuse midline glioma is diffuse)

66
Q

Neuro child lesions: Brainstem with CN6/7 affected, CT-iso/hypo, calcs

A

Diffuse midline glioma/Pontine astrocytoma
(Compare medulloblastoma is CT-hyper. Compare pilocytic astrocytoma is focal)

67
Q

Neuro lesions: CPA invasive

A

Schwannoma

68
Q

Neuro lesions: CPA non-invasive, calcs

A

Meningioma

69
Q

Neuro lesions: CPA, T1-hyper

70
Q

Neuro lesions: CPA, fat-sat hypo

71
Q

Neuro lesions: CPA, T1-hypo, Flair-hypo

A

Arachnoid cyst (CSF signal)

72
Q

Neuro lesions: CPA, T1-hypo, Flair-hyper

A

Epidermoid

73
Q

Neuro lesions: Invades skull

A

HaemangioPeriCytoma

74
Q

Neuro lesions: Lateral ventricles adult

A

“SIDE-cytoma” = Neurocytoma

75
Q

Neuro lesions: Lateral ventricles child

A

“SIDE-cytoma” = SEGA

76
Q

Neuro lesions: Midline ventricles adult

A

“MID-moma” = SubEpendymoma

77
Q

Neuro lesions: Midline ventricles child

A

“MID-moma” = Ependymoma (subependy in adult)

78
Q

Neuro lesions: Midline ventricles T1-hyper

A

Colloid cyst

79
Q

Neuro lesions: Cerebellum/roof 4th ventricle, CT-hyper

A

MedulloBlastoma (CT-hyper unlike astro, homo enhancement, midline cerebellum/4th vent with hydrocephalus)

80
Q

Neuro lesions: Choroid plexus, hydrocephalus, non-invasive, unilateral, homogeneous enhancement

81
Q

Neuro lesions: Choroid plexus, hydrocephalus, unilateral, heterogeneous enhancement, cystic/necrotic

82
Q

Neuro lesions: Choroid plexus, Papilloma vs carcinoma vs xanthogranuloma

A

Papilloma = Unilateral, homogeneous enhancement
Carcinoma = Unilateral, heterogeneous enhancement, cystic/necrotic
Xanthogranuloma = Bilateral

83
Q

Neuro lesions: Choroid plexus,bilateral

A

XanthoGranuloma

84
Q

Neuro lesions: Skull base, midline

85
Q

Neuro lesions: Skull base, para-midline

A

ChondroSarcoma

86
Q

Neuro lesions: Pineal, homogeneous

87
Q

Neuro lesions: Pineal, heterogeneous

88
Q

Neuro lesions: Pineal, fatty

89
Q

Neuro lesions: Pineal, calcs

A

PineloBlastoma

90
Q

Neuro lesions: Pituitary, T1-hypo, T2-hyper, enhancing

91
Q

Neuro lesions: Pituitary, T1-var-hyper, T2-hyper with T2-hypo central nodule, non-enhancing

A

Rathke cleft cyst

92
Q

Neuro lesions: Pituitary, T1-hyper, after pregnancy

A

Sheehan/Apoplexy

93
Q

Neuro lesions: Pituitary, T2-hypo during pregnancy

A

Autoimmune/lymphocytic hypophysitis

94
Q

Neuro lesions: Supra-sellar T1/T2-hyper

A

CranioPharyngioma (“cranium + pharynx”)

95
Q

Neuro lesions: Craniopharyngioma vs pit adenoma

A

T1-var, T2-hyper: Adenoma (<1cm micro/functional, >1cm macro/non-functional but mass effect)

T1-hyper, T2-var solid-cystic with calcs, enhancing, CN palsy/headache/growth retardation: CranioPharyngioma

(Note: Suprasellar and calcs = Craniopharyngioma. Intra-sellar centered with pituitary fossa enlargement, no calcs = Macroadenoma)

96
Q

Neuro lesions: Calcs in basal ganglia

97
Q

Neuro lesions: Calcs in sub-ependymal nodules

A

Tuberous sclerosis

98
Q

Neuro lesions: Calcs in gyrus

A

Sturge-weber

99
Q

Neuro lesions: Peri-ventricular calcs

100
Q

Neuro lesions: Calcs in temporal lobe

A

GanglioGlioma

101
Q

Neuro lesions: Grades of astrocytoma

A

Grade 1 (low grade): 10yo, Sub-ependymal giant cell astrocytoma (“SEGA”) intraventricular mass in tuberous sclerosis child.
Grade 2 (diffuse): 30yo, Non-enhancing, T2-Hyper with Flair-iso.
Grade 3 (anaplastic): 50yo, Enhancing, T2-Hyper with Flair-iso.
Grade 4 (GBM): 70yo, Enhancing, T2/Flair-Hyper.

102
Q

Neuro lesions: Dural mets, ?primary

103
Q

Neuro lesions: Multiple dural and leptomeningeal thickened lesions with neuro symptoms ++

A

NeuroSarcoid

104
Q

Neuro Foramen contents: Optic canal

A

CN2, vision

105
Q

Neuro Foramen contents: Superior orbital fissure

A

3, 4, V1, 6 (eye movements, pupil constriction)

106
Q

Neuro Foramen contents: Cavernous sinus

A

3, 4, V1, V2, 6, carotid

107
Q

Neuro Foramen contents: Foramen rotundum

A

V2 (mid-face sensory) (“R2 V2, rotun2um”)

108
Q

Neuro Foramen contents: Foramen ovale

A

V3 (lower face sensory, anterior tongue sensory) (“oVal3”)

109
Q

Neuro Foramen contents: Foramen spinosum

A

MMA (“SpinosuMM”)

110
Q

Neuro Foramen contents: Meckels

A

CN5 (“meckel5”)

111
Q

Neuro Foramen contents: CPA

A

5, 7, 8, AICA

112
Q

Neuro Foramen contents: Dorello’s canal

A

6 (opposite of CPA) (“dorello = dorel6”)

113
Q

Neuro Foramen contents: IAM

A

7, 8 (hearing/balance/facial movements)

114
Q

Neuro Foramen contents: Jugular foramen

A

CN 9 (posterior tongue sensory and throat), 10 (autonomic), 11 (shoulder/neck movement)

115
Q

Neuro Foramen contents: Hypoglossal canal

A

CN 12 (tongue movement)

116
Q

Hydrocephalus, Asymmetrical

A

Non-communicating, from intra-ventricle obstruction

117
Q

Hydrocephalus, Symmetrical

A

Communicating, from extra-ventricle obstruction (meningitis, SAH, trauama, venous thrombosis)

118
Q

Hydrocephalus, Gait disturbance, confusion, urinary incontinence

119
Q

Signs of Cerebral Amyloid angiopathy (CAA)

A

***Cerebral Amyloid angiopathy (CAA): Intracranial haemorrhages/subarachnoid haemorrhages/microhaemorrhages with siderosis (haemosiderin deposits, appearing as T2 susceptibilities)

120
Q

Neuro child lesions: Child temporal lobe, cyst with nodule and dural tail

A

Pleomorphic XanthroAstrocytoma

121
Q

Neuro child lesions: Child temporal lobe, Bubbly mixed cystic-solid, NON-ENHANCING

A

DNET (“DCBNET”: Doesn’t enhance (usually), Child, Bubbly, Nodular-cystic, Epilepsy, Temporal lobe)

122
Q

Neuro child lesions: Temporal lobe, mixed solid-cystic with calcs

A

GanglioGlioma (also affects adults)

123
Q

Neuro lesions: Arachnoid cyst vs Epidermoid vs Dermoid

A

Dermoid (T1-hyper)
Lipoma (Fat-sat hypo)
Arachnoid cyst (CSF so T1-hypo, Flair-hypo)
Epidermoid (T1-hypo, Flair-hyper)

124
Q

Neuro lesions: Mnemonic for Adult tumours

A

“OLGGH” = Frontal Oligo, Peri-vent homogeneous lymphoma, Temporal GG, Cerebellar in adult Haemangioblast, Anywhere Astrocytoma/GBM (calcs/multi)

125
Q

Neuro lesions: Mnemonic for Child temporal lobe

A

“GDPxa” = Pleomorphic XanthroAstrocytoma (nodulocystic with dural tail), GanglioGlioma (mixed cystic-solid/calcs) and DNET
DNET “DCBNET” = DNET, Child, Bubbly, Nodular-cystic, Epilepsy, Temporal lobe

126
Q

Neuro lesions: Mnemonic for Infra-tentorial child

A

“TPM” = Teratoma (hetero enhancement), Pilocytic astro (solid-cystic nodular), MedulloBlast (homo enhancement)

127
Q

Neuro lesions: Non-enhancing CPA lesions x4

A

Dermoid (T1-hyper)
Lipoma (Fat-sat hypo)
Arachnoid cyst (CSF so T1-hypo, Flair-hypo)
Epidermoid (T1-hypo, Flair-hyper)

128
Q

Neuro lesions: Enhancing CPA lesions x3

A

CPA/Cranial nerve, heterogeneous enhancement, INVASIVE: Schwannoma

Bilateral CPA Schwannoma: NF2

***CPA, homogeneous enhancement, non-invasive, calcification: Meningioma (“Men are gay/homo, Swans are hetero”)

129
Q

Neuro lesions: Mass involving 3+ lobes

A

Gliomatosis cerebri

130
Q

Neuro lesions: What is Parinaud syndrome

A

Mass effect with compression of tectal plate from pineal tumours, thus unable to vertical gaze

WlwG Old (22 decks)

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